Asthma

“Treat your symptoms before they get out of control. Don’t feel too proud to get treatment. Know your limits! Remember to follow all of your doctor’s instructions and don’t be afraid to ask questions.”

Dave S., University of Michigan

Asthma is a disease that affects the air passages in the lungs. People with asthma have supersensitive airways. Exposure to “Asthma Attack Triggers” (see below) causes a response in the airways, called an “attack” or “episode.”

Signs & Symptoms

	A cough that lasts more than a week
	Shortness of breath
	Breathing gets harder and may hurt. It is harder to breathe out than in.
	Wheezing (a whistling sound while breathing)
	Tightness in the chest

{Note: Symptoms are worse at night.}

Causes & Risk Factors

The cause for asthma is not known. You are more likely to have asthma if other members of your family have it and/or you have allergies.

Asthma is not caused by emotional problems. Strong emotions can bring on an asthma attack, though.

Asthma Attack Triggers

	Respiratory infections (colds, flu, bronchitis, sinus infections)
	Things you are allergic to, such as pollen, dust, molds, and dander (small pieces of skin or feathers from an animal) Irritants, such as tobacco smoke, air pollution, fumes, perfumes, colognes, air fresheners, etc.
	Sulfites. These are additives found in wine and some processed foods.
	Cold air and changes in temperature and humidity
	Exercise, especially outdoors in cold air
	Some medicines, such as aspirin
	Strong feelings, including laughing and crying
	Hormone changes, such as those that come with menstrual periods

Treatment

Asthma has no cure, but it is very treatable. It is too complex to treat with over-the-counter products, though. A health care provider should diagnose and treat asthma. He or she may prescribe:

	Anti-inflammatories. These drugs help with swelling in the airways. They are taken as oral pills or inhaled medicines.
	Bronchodilators. These drugs relax the muscles of the airways and open up the air passages in the lungs. A metered-dose inhaler with a device called a spacer is a common way to take these drugs.
	Leukotriene modifiers to help reduce chronic inflammation
	Peak flow meter to self-monitor your asthma at home
	Annual flu vaccine

If you have asthma, you should have an annual physical exam to detect any problems and to evaluate your use of medicines.

Questions to Ask

Do you have asthma with any of these problems? Blue lips or fingernails Extreme shortness of breath. (It may feel as if you can’t breathe at all or you can’t say 4 or 5 words between breaths.) Listlessness or severe weakness Dizziness; fainting

Do you have asthma with any of these problems? Wheezing and you are currently taking steroid medicine or wheezing that doesn’t stop after your prescribed treatment Coughing so much that you can’t take a breath A fever with heavy breathing

Do you have asthma and use the Peak Flow Zone System and is your peak expiratory flow rate (PEFR) below 50% of your personal best number?

Do you have asthma with any of these problems? You can’t walk up a flight or more of stairs or between rooms. You can’t sleep or eat due to shortness of breath.

Do you have asthma, are you taking steroid medicine, and do you have a cold, the flu, or bronchitis?

Do you have asthma and use the Peak Flow Zone System and is your peak expiratory flow rate (PEFR) 50 to 80% of your personal best number?

Do you have asthma and have symptoms at rest, with exercise, early in the morning, or at night?

Do you have asthma and any of the following problems that are not managed with adjustments in medication as instructed in your personal action plan? Breathing faster than usual or it is harder to breathe Shortness of breath occurs more often. A cough which keeps you awake at night An asthma attack does not respond to prescribed medication and/or self-care like it used to. Asthma attacks are coming more often and/or are getting worse.

Have you not been diagnosed with asthma, but have any signs and symptoms of asthma listed above?

Do you use your bronchodilator more than 2 times a week?

Do you have asthma and have any of these problems? You cough at night or have a cough that does not respond to medication. You are not sleeping well. You are tired or are less able to perform daily activities.

Do you have asthma and need medicine refills?

Self-Care

Along with your prescribed medical treatment:

	Drink 2 to 3 quarts of fluids a day to keep secretions loose.
	Don’t smoke. Avoid secondhand smoke and air pollution.
	Avoid your asthma triggers and try to keep your dorm room or bedroom allergen-free: Vacuum and dust often. Wear a dust filter mask when you do. Sleep with no pillow or the kind your doctor recommends. Wash pillows and sheets weekly. Replace pillows every 2 to 3 years. Totally enclose your mattress, box springs, and pillows in allergen-proof covers. Wash mattress pads in hot water every week. Use curtains and throw rugs that can be washed often. Don't use carpeting
	Stay out of the cold weather as much as you can. When you are outside in cold weather, wear a scarf around your mouth and nose to warm the air as you breathe in.
	Stop exercising if you start wheezing.
	Use your peak flow meter as advised. Keep records of results.
	Don’t take over-the-counter medicines unless cleared first with your health care provider. Take your medicines as prescribed.
	Keep your medicine for asthma attacks handy. Take it at the start of an attack.
	During an asthma attack, sit up; don’t lie down. Keep calm. Focus on breathing slow and easy. Remove yourself from any stressors.

For Information, Contact:

The Asthma and Allergy Foundation of America
1-800- 7-ASTHMA (727-8462) or visit www.aafa.org.

National Heart, Lung and Blood Institute (NHLBI)
1-800- 575-WELL (575-9355) or visit www.nhlbi.nih.gov.

Table of Contents

July 19, 2002